The Nasal Cavity and Paranasal Sinuses: Surgical Anatomy

147 Pages·2001·29.49 MB·English

by  João A. C. Navarro

Navarro· The Nasal Cavity and Paranasal Sinuses
Springer-Verlag Berlin Heidelberg GmbH
Jo ao A. C. N avar ro
The Nasal Cavity
and
Paranasal Sinuses
Surgical Anatomy
Coauthors Jo ao de Lima Na var ro
Paulo de Lima Navarro
With 150 Color Figures
Springer
Joao A.C. Navarro Translators:
Professor and Chairman of Anatomy
Department of Morphology Dr. Mârcia Murao
Dental School of Bauru
Dr. Suzana M. de Oliveira
University of Sao Paulo
Bauru,SP
Brazil
Joao de Lima Navarro
Graduate in Computer Sciences
Exact Sciences Center
State University of Londrina
Londrina, Parana
Brazil
Paulo de Lima Navarro
Medical Doctor
Health Sciences Center Original Edition:
State University of Londrina joăo A.C. Navarro
Cavidade do Nariz e Seios Paranasais
Londrina, Paran a
(Anatomia Cinlrgica 1)
Brazil © AII Dent. (Bauru) 1997
Library of Congress Cataloging-in-Publication Data
Navarro, Joăo A.C. (Joăo Adolfo Caldas), 1939. The nasal cavity and
paranasal sinuses: surgical anatomy I Joăo A.C. Navarro; [contri
butor, Paulo de Lima Navarro]. p.; cm. - (Surgical anatomy).
Includes bibliographical references and index.
1. Nasal fossa-Anatomy. 2. Paranasal sinuses-Anatomy. 3. Anatomy,
Surgical and topographical.l. Navarro, Paulo de Lima. II. Title. III.
Series.
ISBN 978-3-642-63187-0 ISBN 978-3-642-56829-9 (eBook) [DNLM: 1. Nasal Cavity-anatomy & histology. 2. Nasal Cavity-sur
DOI 10.1007/978-3-642-56829-9 gery. 3. Paranasal Sinuses-anatomy & histology. 4. Paranasal Sinu
ses-surgery. WV 301 N322n 2001]
QMSOS .N38S 2001 611'.92-dc21 00-061189
This work is subject to copyright. AII rights are reserved, whether
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© Springer-Verlag Berlin Heidelberg 2001
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Printed on acid-free paper 24/3130/PF ications contained in this book. In every individual case the user
543210 must check such information by consulting the relevant literature.
To MY WIFE FIDELA,
AND TO MY SONS
PAULO, JOAO, MARCOS, AND RICARDO,
FOR THEIR LOVE AND INVOLVEMENT
Foreword
The evolution of microscopic and endoscopic sur ic references of the nose, paranasal sinuses, and re
gery of the nose was made possible due to the de lated structures, essential for everyone concerned
tailed knowledge acquired by anatomists and sur with microendoscopic surgery of the paranasal si
geons on the macro- and microanatomy of this re nuses.
gion. I would like to thank Prof. Navarro once more
Unveiling the complex structure of the middle for his teachings, which have greatly contributed to
third of the face has always been a challenge to my own professional development and to that of so
Prof. Navarro. The contribution of his studies to many colleagues all over the world.
the many specialties is immeasurable. The present
work comprises information on the main anatom- Aldo Stamm
Preface
In the field of health sciences, steady and rapid ad under the surgical microscope), which are useful
vances in knowledge demand from the profession for microsurgery and endoscopic surgery within
al true commitment and continued efforts to keep several medical specialties.
abreast of the times. For the medical surgeon, a To fill this gap, information based on the cur
deep knowledge of basic biology and anatomy be rent literature and on our own experience in anat
comes more and more necessary, considering the omy acquired over the years has been collected in
diagnostic advances and the refinement of surgical this publication. This study of the nasal cavity and
techniques which have been made possible by the paranasal sinuses focuses on their osteological as
development of novel equipment and modern pects, anatomical relationships, and the sites for
tools. Since ancient times, a deep understanding of surgical access to the paranasal sinuses.
anatomy has stood out as an essential requirement Anatomical aspects of the skull and cadaver
for surgical activities. were analyzed and compared with those in the liv
The anatomy textbooks and atlases currently ing, in order to highlight the regions posing an en
available for students and clinicians, many of hanced surgical risk. Notes of surgical relevance
them dating from previous centuries, are often are synthetically presented at the end of the text,
not up-to-date. They usually lack important in constituting an overview of the most important
formation on anatomical variations naturally oc anatomical relationships and aiming to provide
curring in individuals, especially those of the the reader with a useful and practical guide to
deep craniofacial regions. Moreover, specialized microsurgery and endonasal endoscopic surgery.
publications hardly ever include mesoscopic ana
tomical preparations (preparations carried out J. Navarro
Acknowledgements
My deepest recognition and appreciation are of To the staff of the City Hall, the Centrinho, and
fered to my teacher and friend Dr. Aldo C. Stamm, the FOB, who were collaborative and helpful
for his vast contribution to the excellence of the an throughout.
atomic principles applied to microsurgery and en To the Brazilian and foreign otorhinolaryngolo
doscopic surgery. gists with whom I have had the opportunity to work.
To the Brazilian Society of Otorhinolaryngolo
gy and the Brazilian Society of Rhinology and Es
To Prof. Dr. Dagoberto Sottovia Filho, Director of thetic Facial Surgery, for the qualified support they
the Bauru School of Dentistry (University of Sao gave to our enterprise.
Paulo), and to Prof. Dr. Jose Alberto de Souza Frei To Drs. Eulalia Sakano, Elizabeth Araujo Pere
tas, General Director of the Labiopalatal Damages ira, Rainer Haetinger, Antonio Douglas Menon,
Recovery Hospital (University of Sao Paulo), for Alexandre Fellippu, Roberto M. Neves Pinto, Carlos
their encouragement and support of our projects Alberto H. Campos, Lidio Granato, Pedro O.
and myself; to my sons Paulo de Lima Navarro and Cavalcanti, Antonio Carlos Cedin, Jose Francisco
Joao de Lima Navarro, who, with much personal ef Chagas, Nelson Caldas, and Washington Luiz C.
fort, contributed greatly to the preparation of the Almeida, for their encouragement and friendship.
manuscript; to Dr. Regina Celia Baptista Belluzzo, To the Otorhinolaryngology and Phonoaudio
Technical Director of the Library and Documenta logy Center (COF) and to the Edmundo Vasconce
tion Service, and to Eliane Falcao Tuler Xavier, los Hospital, for the opportunity to participate in
Technical Head of the Library Service of Docu the microsurgery and endonasal endoscopic sur
mentation and Publicity of the Bauru School of gery courses over so many years, under the super
Dentistry, (University of Sao Paulo), for their excel vision of Dr. Aldo Stamm.
lent job and unselfish dedication. To each I extend To Doc Med, for their kind support and friend
my deepest appreciation. ship; to Byk Qufmica, for their permanent commit
To my colleagues Prof. Dr. Neivo Luiz Zorzetto, ment to scientific development, and to Richards do
Joao Lopes Toledo Filho, and Jesus Carlos Andreo, Brasil for their immeasurable help and encourage
for their supportive collaboration; to the research ment.
ers Regina Papassoni Santos, Erica A.P. Oliveira, The participation of so many valuable people
and Silmara Valderez Zamboni; to the members of has been crucial to the undertaking of this project.
our staff Mr. Orivaldo da Silva, Mr. Romario M. de To all, my sincerest gratitude.
Arruda, and Ms. Eugenia D. Meggiato, for their per
manent interest; to Claudia V. de Oliveira and Gis
lene S. de Moraes, for their diligence and unfailing My special thanks go to Dr. Suzana Macedo de
efficiency. I extend my special recognition to all of Oliveira and Dr. Marcia Murao, for their transla
them and hope we will continue to work together. tion of this book into the English language.
Contents
Chapter 1 Development and Growth
of the Nasal Cavity
and Paranasal Sinuses .....................
Chapter 2 Anterior Aperture of the Nasal Cavity ...... 25
Chapter 3 Posterior Aperture of the Nasal Cavity ..... 31
Chapter 4 Lateral Wall of the Nasal Cavity ............ 37
.............................
Chapter 5 Nasal Septum 55
Chapter 6 Arteries and Nerves of the Nasal Cavity
.....................
and Paranasal Sinuses 61
Chapter 7 Maxillary Sinus 71
Chapter 8 Frontal Sinus .............................. 83
Chapter 9 Ethmoidal Sinus .......................... 93
Chapter 10 Sphenoidal Sinus ......................... 105
Chapter 11 Cranial Base and Paranasal Sinuses ........ 115
Chapter 12 Notes of Anatomosurgicallmportance ..... 125
Recommended Reading ................... 135
Subject Index ............................. 141
Chapter 1 _________
Development and Growth
of the Nasal Cavity
and Paranasal Sinuses